Prevention Guidelines for Women 40–49

Here are the screening tests and immunizations that most women ages 40 to 49 need. This plan does not include recommendations for pregnancy. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion.

Screening

Who needs it

How often

Type 2 diabetes or prediabetes

All adults beginning at age 45 and adults with no symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes

At least every 3 years

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:

Every 2 years if your blood pressure reading is less than 120/80 mm Hg, or

Screening with a mammogram every year is an option starting at age 40. At age 45 start yearly mammograms.*

Cervical cancer

All women, except those who had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and no history of cervical cancer or serious precancer

Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called "co-testing") every 5 years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every 3 years.

Chlamydia

Women at increased risk for infection

At routine exams if at risk

Depression

All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up

At routine exams

Gonorrhea

Sexually active women at increased risk for infection

At routine exams if at risk

Hepatitis C

Anyone at increased risk; 1 time for those born between 1945 and 1965

At routine exams if at risk

HIV

All women

At routine exams

Lipid disorders

All women age 45 and older at increased risk for coronary artery disease

For women ages 19 to 44, screening should be based on risk factors1; discuss with your healthcare provider

At least every 5 years

Obesity

All adults

At routine checkups

Syphilis

Women at increased risk for infection

At routine exams if at risk

Tuberculosis

Anyone at increased risk for infection

Check with your healthcare provider

Vision

All adults2

Baseline comprehensive exam at age 40; if you have a chronic disease, check with your healthcare provider for exam frequency

Counseling

Who needs it

How often

Breast cancer, chemoprevention

Women at high risk

When risk is identified

BRCA mutation testing for breast and ovarian cancer susceptibility

Women with increased risk

When risk is identified

Diet and exercise

Adults who care overweight or obese

When diagnosed and at routine exams

Domestic violence

Women of child-bearing age

At routine exams

Sexually transmitted disease prevention

Anyone at increased risk for infection

At routine exams

Tobacco use and tobacco-related disease

All adults

Every exam

Immunization

Who needs it

How often

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All adults

Td: every 10 years

Tdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years

Chickenpox (varicella)

All adults in this age group who have no record of previous infection or vaccinations

2 doses; the second dose should be given at least 4 weeks after the first dose

Measles, mumps, rubella (MMR)

All adults in this age group who have no record of previous infection or vaccinations

1 or 2 doses

Flu vaccine (seasonal)

All adults

Yearly, when the vaccine becomes available in the community

Hepatitis A vaccine

People at risk3

2 doses given 6 months apart

Hepatitis B vaccine

People at risk4

3 doses; the second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)